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NPI Code Detail

MEDICARE: YASIN AMDANI PHARMD

MEDICARE: YASIN AMDANI PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist37460TN

General Provider Information

NPI Number : 1952743148
Entity Type Code : Individual
Provider Name (Legal Business Name) : YASIN AMDANI PHARMD
Provider Business Mailing Address
First Line : 701 SWADLEY RD APT 1
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-9034
Country : US
Telephone Number : 423-202-7189
Fax Number :
Provider Business Practice Location Address
First Line : 3900 FORT HENRY DR
Second Line :
City : COLONIAL HEIGHTS
State : TN
Zip : 37663-2026
Country : US
Telephone Number : 423-239-6845
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2013
Last Update Date : 08/02/2013

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